Ultrasound (US) prenatal screening has been proposed as the most effective technique for Trisomy 21 early assessment. Assessment of Nuchal Translucency (NT) offers promising non-invasive method for fetal abnormalities detection up to 75%. Nevertheless, current clinician practice of NT examination by locating the sonogram calipers on 2D US image requires highly trained and competent operators by adhering to a standard tedious protocol; therefore it is prone to errors and hence it decreases the reliability in intra- and inter-observer repeatability. This Brief provides the basic knowledge regarding Trisomy 21 diseases and its existing detection methods. The restrictions and disadvantages of each method are discussed accordingly. Therefore, a non-invasive early detection method using 3D ultrasound reconstruction of Nuchal Translucency is introduced. This new method for 3D NT assessments has an edge over the previous 2D methods, and entails the composite function in visualizing the explicit internal marker structure. Further, image processing techniques covered from data acquisition, pre-processing, speckle noise reduction and 3D segmentation are also discussed. This should be especially useful for students and professional researchers in the Biomedical and image processing fields.

Agreed standards and guidelines are the heart and soul of improving the differing training systems and to harmonize neurosurgical training in the European countries. Such standards and guidelines have been laid down in the European Training Charter of the European Union of Medical Specialists and recently novellated. This book, written by experienced neurosurgeons, offers all those concerned with neurosurgical training - trainers and trainees - practical advice to implement the above mentioned standards and recommendations. It has been written as a manual: "How to do it." It describes the tasks of a chairman (programme director), the tasks of the teaching staff, the organisation of a training curriculum, a rotation plan or a morbidity and mortality conference, the periodic progress evaluation, the course of an external audit and many more important topics. It contains a lot of practical tips, check lists and useful examples. Well educated young colleagues offer "safe neurosurgery" to our patients.

The first edition of this definitive text ran to 24 chapters. The second edition, reflecting the explosive growth of interest in echo-enhancement, contains 44. The first section deals with some of the most important emerging issues and technologies and covers harmonic imaging, the use of echo-enhancers to provide quantitative information, and the application of enhanced power Doppler to tissue imaging. The second, on contrast echocardiography, explores the use of echo-enhancement during transesophageal imaging. One chapter describes the use of contrast-enhancement transesophageal imaging to determine coronary flow reserve and another gives a detailed account of the application of the technique to the evaluation of left ventricular function. Other authors describe the intraoperative use of contrast echocardiography and discuss the potential of myocardial contrast echocardiography to replace thallium scintigraphy. Another chapter covers the emerging technique of transient response imaging and its role in the assessment of myocardial perfusion, and two chapters are devoted to three-dimensional contrast echocardiographic assessment of myocardial perfusion. Use of echo-enhancement in the evaluation of peripheral circulation is discussed in chapters on carotid and peripheral arterial flow imaging and others that describe renal and hepatic vascular imaging. The newer applications of echo-enhancement outside the cardiovascular system are described in three chapters devoted to the visualization of tumour vasculature. The final chapters look to the future and cover the imaging of intramyocardial vasculature, the development of site-specific agents and the emergence of the new acoustically active agents.

As an addition to the European postgraduate training system for young neurosurgeons we began to publish in 1974 this series devoted to Advances and Technical Standards in Neurosurgery which was later sponsored by the European Association of Neurosurgical Societies. The fact that the English language is well on the way to becoming the international medium at European scientific conferences is a great asset in terms of mutual understanding. Therefore we have decided to publish all contributions in English, regardless of the native language of the authors. All contributions are submitted to the entire editorial board before publication of any volume. Our series is not intended to compete with the publications of original scientific papers in other neurosurgical journals. Our intention is, rather, to present fields of neurosurgery and related areas in which important recent advances have been made. The contributions are written by specialists in the given fields and constitute the first part of each volume. In the second part of each volume, we publish detailed descriptions of standard operative procedures, furnished by experienced clinicians; in these articles the authors describe the techniques they employ and explain the advantages, difficulties and risks involved in the various procedures. This part is intended primarily to assist young neurosurgeons in their post graduate training. However, we are convinced that it will also be useful to experienced, fully trained neurosurgeons."

It is now 150 years ago, on 25th May 1842, that the son of a Salzburg ston emason presented a scientific work "On the coloured light of the double stars and certain other heavenly bodies" at a meeting of the Royal Bo hemian Society of Sciences held in Prague. Christian Andreas Doppler, then professor at the Prague Technical Institute, set a milestone in scien tific history in the meeting room of the Royal Society in the Charles Uni versity, just a few meters from the National Theatre where another genius from Salzburg, Wolfgang Amadeus Mozart, had celebrated his musical triumph with the premiere of his opera Don Giovanni fifty-five years earlier. Doppler's lecture set out in brilliant simplicity what we now call the Doppler principle, which since has found numerous uses in astronomy, which was of primary interest to Christian Doppler. In addition, it has found countless practical applications in physics, navigation, aeronautics, geodesy, medicine, science and technology. In medicine alone, Doppler sonography is now an established diagnostic procedure in the fields of childbirth, cardiology and diseases of the blood vessels, neurology, neuro surgery and vascular surgery, and is continually finding new medical appli cations in today's world of high technology."

Parameters such as membrane transport, metabolism and protein incorporation govern the fate of amino acids in living tissue. Is it possible to use positron tomography to measure some of them, and what is their meaning in normal and pathological situations? These questions have been addressed for a long time and no satisfactory answer has yet been given. This book, which derives from an EEC workshop organized in the frame of the Concerted Action on PET Investigation of Cellular Regeneration and Degeneration', held in Lyon in February 1992, gives the present state of knowledge in this field based on the most recent studies. Contributions from 24 leading European and American scientists are presented and discussed in the following four parts: biochemistry and animal studies; amino acids labelling with positron emittors, quality control and metabolites measurement; kinetic modelling of amino acids transport, metabolism, and protein incorporation; clinical use of amino acids. This book will aid and interest biochemists, radiochemists, pharmacologists, neurologists, oncologists and medical imaging scientists.

Specialists in cardiac imaging offer their extensive experience of performing and interpreting myocardial perfusion studies with thallium 201 and single photon emission tomography in this unique teaching atlas which contains over 1500 colour illustrations.

This is the fourth volume of Ultrasound in Medicine, the Proceedings of the Annual Scientific Meeting of the American Institute of Ultrasound in Medicine. Unless the Executive Board of the Institute change their mind, it may also be the last. Under these circumstances it is somewhat ironical that some of the deficiencies present in previous volumes appear to have been solved in the present volume. Notably, the Programme Committee, for the first time, exercised a stringent selection procedure by means of which the number of papers selected for presentation was limited with the result that both the quality of papers accepted for presentation and publication was improved and the number of simultaneous sessions at the meeting did not exceed two. The contents of this volume have been divided into the same sections as in previous volumes except that no papers on stan dardization procedures were accepted and a new supplementary section is added consisting of papers given at the Scientific Meeting of the American Society of Ultrasound Technical Specia lists. As in previous editions the readers may consider the engin eering sections at the end of this volume are the most rewarding. Some ingenious new systems are described both in the sections on Doppler techniques and new techniques. Current interest in tissue signatures and characterization are reflected in many of the pap~rs appearing in the Tissue Interactions section.

New Frontiers in Biomedical Engineering will be an edited work taken from the 1st Annual World Congress of Chinese Biomedical Engineers - Taipei, Taiwan 2002. As the economy develops rapidly in China and the Asian-Pacific population merges into the global healthcare system, many researchers in the West are trying to make contact with the Chinese BME scientists. At WCCBME 2002, invited leaders, materials scientists, bioengineers, molecular and cellular biologists, orthopaedic surgeons, and manufacturers from P.R. of China, Taiwan, Singapore and Hong Kong covered all five major BME domains: biomechanics, biomaterials and tissue engineering, medical imaging, biophotonics and instrumentation, and rehabilitation. This edited work taken from the World Congress proceedings will capture worldwide readership.

This book provides a complete overview of all modalities used for hand and wrist imaging, along with a complete over- view of the various disease entities that can be diagnosed. As a state-of-the-art overview of hand and wrist imaging it is a reference work for radiologists, hand surgeons, ortho- pedists, traumatologists, rheumatologists and internists and their residents in training. The chapters are written by ex- perts in musculoskeletal radiology from various European countries and the USA.

The articles collected in this volume are based on lectures given at the IMA Workshop, "Computational Radiology and Imaging: Therapy and Diagnostics", March 17-21, 1997. Introductory articles by the editors have been added. The focus is on inverse problems involving electromagnetic radiation and particle beams, with applications to X-ray tomography, nuclear medicine, near-infrared imaging, microwave imaging, electron microscopy, and radiation therapy planning. Mathematical and computational tools and models which play important roles in this volume include the X-ray transform and other integral transforms, the linear Boltzmann equation and, for near-infrared imaging, its diffusion approximation, iterative methods for large linear and non-linear least-squares problems, iterative methods for linear feasibility problems, and optimization methods. The volume is intended not only for mathematical scientists and engineers working on these and related problems, but also for non-specialists. It contains much introductory expository material, and a large number of references. Many unsolved computational and mathematical problems of substantial practical importance are pointed out.

W. F. ARMSTRONG While stress echocardiography is not the first technique to be applied to patients for the diagnosis of coronary artery disease, it represents an impor tant clinical tool, likely to become of increasing pertinence in today's era of cost containment and mandated cost-effectiveness of diagnosis. It may be the most rapidly expanding area of clinical echocardiography today. Stress echocardiography as we know it today represents the natural con clusion and merger of observations made over fifty years ago. In 1935 Tenn ant and Wiggers demonstrated that the immediate result of a coronary oc clusion, was an instantaneous abnormality of wall motion [1]. As viewed from the surface of the heart in an open chest dog preparation, cyanosis and obvious paradoxical bulging of the left ventricular wall was noted. At a similar time Masters and co-workers, using fairly rudimentary exercise de vices, described the response of the human cardiovascular system to sustained exercise (Figure 1) [2]. These two observations diverged for four decades while clinical investigation was pursued along the two parallel lines.

This book constitutes the Proceedings of the 26th Symposium on Acoustical Imaging held inWindsor, Ontario, Canada during September 9-12, 2001. This traditional scientific event is recognized as a premier forum for the presentation of advanced research results in both theoretical and experimental development. The lAIS was conceived at a 1967Acoustical Holography meeting in the USA. Since then, these traditional symposia provide an opportunity for specialists who are working in this area to make new acquaintances, renew old friendships and present recent results of their research. Our Symposium has grown significantly in size due to a broad interest in various topics and to the quality of the presentations. For the firsttime in 40 years, the IAIS was held in the province of Ontario in Windsor, Canada's Automotive Capital and City of Roses. The 26th IAIS attracted over 100specialists from 13countries representing this interdisciplinary field in physical acoustics, image processing, applied mathematics, solid-state physics, biology and medicine, industrial applications and quality control technologies. The 26th lAIS was organized in the traditional way with only one addition-a Special Session "History of Acoustical Imaging" with the involvement of such well known scientists as Andrew Briggs, Noriyoshi Chubachi, Robert Green Jr., Joie Jones, Kenneth Erikson, and Bernhard Tittmann. Many of these speakers are well known scientists in their fields and we would like to thank them for making this session extremely successful.

It was only in 1980 that the first recognisable magnetic resonance images of the human brain were published, by Moore and Holland from Nottingham University in England. There then followed a number of clinical trials of brain imaging, the most notable from the Hammersmith Hospital in London using a system designed by EMI, the original manufacturers of the first CT machines. A true revolution in medicine has ensued; in only a few years there are thousands of scanning units, and magnetic resonance imaging (MRI) has assumed a central importance in medical investigation. It is an extraordinary fact that within a few years of development, the esoteric physics of nuclear spin, angular momentum, and magnetic vector precession were harnessed to provide exquisite images of living anatomy; modem science has no greater tribute. That indisputable king of neurology and the oldest of recorded conditions, epilepsy, has not been untouched by the new technology; indeed, it is our view that the introduction of MRI of electroencephalography (EEG) in the late has been as important to epilepsy as was that 1930s. Now, for the first time, the structural and aetiological basis of the condition is susceptible to thorough investigation, and MRI can provide structural detail to parallel the functional detail of EEG. MRI has the same potential as had EEG over 50 years ago, to provide a new level of understanding of the basic mechanisms, the clinical features and the treatment of epilepsy.

Endoanal and endorectal ultrasound represents considerable progress in the field of anorectal imaging. Its importance in the staging of rectal and anal cancer, in identifying perianasto- motic neoplastic recurrences, in defining acute and chronic suppurative disease and in assessing sphincteral anatomical integrity, is now a confirmed reality. The evidence provided by endoanal and endorectal ultrasonography guides the colorectal surgeon in his choice among the various therapeutic approaches and helps in assessing the effects of the treatments applied. The great flexibility and high degree of reliability make this exploratory method an indispensable tool at all stages of the clinical course in the majority of patients with anorectal problems, including the fundamental follow-up stage. The publication of this excellent volume on intraanal and intrarectal ultrasonog- raphy is therefore to be appreciated, especially since it is in the form of an atlas. As we are dealing with imaging, it is particularly appropriate that it is the images that tell the story. Like all important things, this volume does not come out of nothing. It is the result of many years of skilled work by Drs. G.A. Santoro and G. Di Falco and is based on the experience of internationally renowned professional experts. The ten sections of the atlas begin with general information on ultrasonography, gradually progressing to the technical problems of the method and the aspects rela- tive to anorectal tumors.This last section leads to a review of traditional and mod- ern therapeutic possibilities.

Imaging of the Dopaminergic system in the human brain with the in vivo use of Positron Emis- sion Tomography has emerged in the late 1980s as a tool of major importance in Clinical Neuros- ciences and Pharmacology. The last few years have witnessed the rapid development of new radiotracers specific to receptors, reuptake sites and enzymes of the dopamine system; the application of these radiotracers has led to major breakthroughs in the pathophysiology and therapy of movement disorders and schizophrenic-like psychoses. This book is the first to collect, in a single volume, state-of-the-art contributions to the various aspects of this research. Its contents address methodological issues related to the design, labelling, quantitative imaging and compartmental modelisation of radioligands of the post-synaptic, pre-synaptic and enzyme sites of the dopamine system and to their use in clinical research in the fields of Parkinson's disease as well as other movement disorders, psychoses and neuroleptic receptor occupancy. The chapters were written by leading European scientists in the field of Positron Emission Tomography, gathered together in Caen (France, November 1990) under the aegis of the EEC Concerted Action on "PET Investigations of Cellular Regeneration and Degeneration. This book provides a current and comprehensive overview on PET studies of the brain dopamine system which should aid and interest neurologists, psychiatrists, pharmacologists and medical imaging scientists. J. C. Baron D. Comar L. Farde J. L. Martinot B. Mazoyer August 1991 ix LIST OF CONTRffiUTORS Dr Yves Agid DrL.

The aim of this Atlas is to present the three-dimensional arrangement of the liver structures, which should be familiar to those who diagnose and treat diseases of the liver, particularly in an era when the methods of diagnostic imaging and surgical treatment are becoming increasingly sophisticated. For this purpose a series of corrosive preparations of the blood vessels and bile ducts of the liver was made and photographed. In addition to the normal situations, many frequent and rare variations are shown. The Atlas also shows some blood vessels that have not been adequately described or are not well-known in the reference literature, but are nevertheless of great importance in performing segmental liver resections.This Atlas takes a fresh approach to the subject. The method used allows the size, three-dimensional arrangement and structure of the blood vessels and bile ducts of the liver to be preserved. The majority of photographs were taken from the direction from which surgeons see the liver during an operation. This, together with the schematic presentations complementing most of the photographs, gives a further instructional value to the work. With colour photographs and explanatory text, the Atlas forms a basic guide to orientation inside the liver parenchyma, to understanding and diagnosing certain pathological processes and to planning surgcial procedures.

The Association Internationale de Recherche sur la Circulation Osseuse, A.R.C.O., was founded in London in December 1989 by a small group of doctors, surgeons and researchers in basic sciences who had been involved for many years in the study of bone circulation and its disorders. They had met several times in Toulouse, during the International Symposia on Bone Circulation held there since 1973 and they wished to carry their contacts further. In founding A.R.C.O., they established as their primary aims the encouragement and furtherance of research, organisation of meetings and promotion of knowledge on the subject. At the present time, the Association has over a hundred members from more than bone tissue twenty countries in Europe, America and Asia. All have the conviction that and its pathology can only be truly known and studied if one has an understanding of its vascular system and the way its circulation functions. This concept, apparently beyond question, has not yet been adopted by all physicians and scientists who are interested in bone. From time to time, one comes across teaching programmes on bone patho logy which make no mention of bone circulation.

Recent years have witnessed dramatic advances in the development and use of magnetic resonance imaging (MRI) techniques that can provide quantitative measures with some degree of pathological specificity for the heterogeneous substrates of multiple sclerosis (MS). Magnetic resonance spectroscopy (MRS) is one of the most promising of these techniques. Thanks to MRS, axonal damage is no longer considered an end-stage phenomenon typical of only the most destructive lesions and the most unfortunate cases, but rather as a major component of the MS pathology of lesions and normal-appearing white matter at all the phases of the disease. This new concept is rapidly changing our understanding of MS pathophysiology and, as a consequence, the therapeutic strategies to modify the disease course favorably. Many of the authors have pionereed the use of MRS in MS, thus contributing to the foundation of the "axonal hypothesis."

The key contribution of the approach to x-ray mammographic image analysis developed in this monograph is a representation of the non-fatty compressed breast tissue that we show can be derived from a single mammogram. The importance of the representation, called hint, is that it removes all those changes in the image that are due only to the particular imaging conditions (for example, the film speed or exposure time), leaving just the non-fatty interesting' tissue. Normalising images in this way enables them to be enhanced and matched, and regions in them to be classified more reliably, because unnecessary, distracting variations have been eliminated. Part I of the monograph develops a model-based approach to x-ray mammography, Part II shows how it can be put to work successfully on a range of clinically-important tasks, while Part III develops a model and exploits it for contrast-enhanced MRI mammography. The final chapter points the way forward in a number of promising areas of research. Audience: This book has been written for a wide readership, including medical image analysts, medical physicists, radiologists, breast surgeons, and research students. The mathematics and algorithms have been relegated to boxes so that the book can be read and understood even if the mathematical detail is skipped. Large parts of the monograph will be of interest to clinicians generally and to patients.

Mathematical morphology (MM) is a theory for the analysis of spatial structures. It is called morphology since it aims at analysing the shape and form of objects, and it is mathematical in the sense that the analysis is based on set theory, topology, lattice algebra, random functions, etc. MM is not only a theory, but also a powerful image analysis technique. The purpose of the present book is to provide the image analysis community with a snapshot of current theoretical and applied developments of MM. The book consists of forty-five contributions classified by subject. It demonstrates a wide range of topics suited to the morphological approach.

Since the introduction of myocardial perfusion imaging and radionuclide angiography in the mid-seventies, cardiovascular nuclear medicine has undergone an explosive growth. The use of nuclear cardiology techniques has become one of the cornerstones of the noninvasive assessment of coronary artery disease. In the past 15 years major steps have been made from visual analysis to quantitative analysis, from planar imaging to tomographic imaging, from detection of disease to prognosis, and from separate evaluations of perfusion, metabolism, and function to an integrated assessment of myocardial viability. In recent years many more advances have been made in cardiovascular nuclear imaging, such as the development of new imaging agents, reevaluation of existing procedures, and new clinical applications. This book describes the most recent developments in nuclear cardiology and also addresses new contrast agents in MRI. What's New in Cardiac Imaging will assist the clinical cardiologist, the cardiology fellow, the nuclear medicine physician, and the radiologist in understanding the most recent achievements in clinical cardiovascular nuclear imaging.

This volume contains the proceedings of the First International Conference on Eicosanoids and Other Bioactive Lipids in Cancer and Radiation Injury held in Detroit, Michigan on October 11-14, 1989. The program consisted of 83 oral and 29 poster presentations, 74 of which are included in these proceedings. The major sponsors of the conference were the Armed Forces Radiobiology Research Institute, located in Bethesda, Maryland, the Radiation Oncology Research and Development Center of the Gershenson Radiation Oncology Center, Harper Hospital in Detroit, Michigan, and Schering AG of West Germany. Eighteen other organizations provided additional support. The conference was unique in its attempt to link the eicosanoid and lipid researchers in the radiobiology and cancer disciplines. The diverse roles that eicosanoids and other bioactive lipids play in these biological phenomena including the participation of lipid oxidation in conversion of procarcinogens, positive and negative modulation of tumor growth, immunomodulation, tissue injury, and yet protection and enhancement of cancer therapy, necessitated scientific interaction to sort out and understand these complex and sometimes contradictory observations. The success of this effort is reflected not only through these proceedings, but also through the decision to continue the conference series with a second meeting to be held in Berlin between September 17-21, 1991.

Magnetic resonance imaging became clinical in 1981 and since that time, has spread in the United States, Europe and Japan like wild fire. The tremendous advantages of the method consisting of safety, superb soft tissue contrast resolution, the ability to study flow, the ability to image in any plane or acquire data in 3D and an almost infinite array of sequences capable of distinguishing between disease and normal tissue, normal and abnormal blood flow make it incomparable for the diagnosis and study of multiple diseases and is particularly valuable in studying the heart and major vessels. The authors of this book have understood that the secret of success of MR imaging in the study of the heart is to combine the knowledge of anatomy of the heart, the coronary vessels, the pericardium and large vessels with the intricacies of MR imaging. This is why they go deeply into the basic principles of NMR, starting from the essentials and going then into detailed techniques of acquiring images from traditional spin echo to gradient echo and ultra fast imaging approaches, such as the multi shot and EPI. The flow phenomena are also discussed in detail from flow and magnetic field gradients diastolic pseudogating.

Physics-Based Deformable Models presents a systematic physics-based framework for modeling rigid, articulated, and deformable objects, their interactions with the physical world, and the estimate of their shape and motion from visual data. This book presents a large variety of methods and associated experiments in computer vision, graphics and medical imaging that help the reader better to understand the presented material. In addition, special emphasis has been given to the development of techniques with interactive or close to real-time performance. Physics-Based Deformable Models is suitable as a secondary text for graduate level courses in Computer Graphics, Computational Physics, Computer Vision, Medical Imaging, and Biomedical Engineering. In addition, this book is appropriate as a reference for researchers and practitioners in the above-mentioned fields.